2012年9月18日 星期二

The Common Cold of Mental Illnesses: Depression

We all have been happy and sad at some point in our life but it's important to realize the difference between mood changes that are normal and those that are extreme. The list of disorders is a lengthy one, with depression ranking as one of the most common. I'm sure you've heard more than once someone saying that they are depressed, and usually what they are describing are their current emotions, not necessarily depression as defined from a clinical standpoint. Sadness, anxiety and any other negative emotion can cause a person to enter a depressed state. Such feelings are most likely followed after a traumatic event such as death in the family, the end of a relationship and/or the loss of a job. Although it is only normal to feel sadness after a painful event, gradually and over time those feelings work themselves out, and mood stability is restored; unfortunately, that is just not the case for everyone. Depression comes in several forms and DSM-IV-TR (diagnostic manual) recognizes two categories: Major depression and dysthymic disorder.

Depression is a very sad state to be in, not only because you feel constantly sad but also because everything around you falls apart. Relationships get destroyed, families fall apart and the world is constantly moving but you are stuck in one place unable to do anything but sit and wonder what's next. The inability to function normally and the frustration inside leads many people to have suicidal thoughts which many peruse. One of my close friends got out of a relationship with her boyfriend of 2 years and she became every depressed. She had difficulty sleeping, ate every little, lost interest in everything around her, lost her job and ended up taking pills to try and catch some sleep. After a year she was finally able to get her life on track and catch up with the rest of the world. If you feel depressed and unable to function after a very sad event, that's only normal but if your depression last more than 3 months that when action should be taken.

Major depression VS Dysthymic disorder

Many people wonder how psychologist determine whether or not we are depressed and if so how severely; let's begin by further explaining major depression.

The diagnosis for major depression requires that the individual experiences either depressed mood or loss of interest in daily activities, work, friendships, relationships; in other word struggling every day in easy to do activities. Also, aside from the above listed, the individual must experience at least four other symptoms of depression. In order to be qualified as legitimate symptoms, they have to be severe enough to interfere with the person's ability to function in everyday life. Dysthymic disorder is a less severe form of depression, the only difference being it is also chronic.To be diagnosed with dysthymic disorder an individual has to experience at least two other symptoms of depression, while at the same time experiencing a depressed mood. As I mentioned before, dysthymic disorder is chronic, and because of that, in order to be diagnosed you must experience the aforementioned symptoms for at least two years. During these two years the person must have ongoing symptoms of depression, and never have been without them for more than two months. An interesting case arises when both disorders are diagnosed in the same patient at the same time. Although the individual will be in the dysthymic mood most of the time, they will also have times when they fall into a major depression. However, even if the major depression episodes will eventually fade away, the individual will still continue to have mild depression, which falls into the category of dysthymic.Moreover, the individual will never return into a normal/stable state of mood.

According to Twenge & Nolen-Heksema 2002, the rates of depression in girls escalates dramatically over the course of puberty, while those of boys do not. It should come as no surprise that girls are more prone to depression than boys. During the adolescence years, girls more than boys are becoming aware of their body. Of course, the most obvious role models girls look up to are those representing the fashion industry. Girls will do anything to look just like their favorite super model. This is what leads thirteen year old girls to significantly higher levels of depression than boys. As I mentioned in my previews blog post "The Veil Of Modeling" "The flawless skin, the "perfect" hair, the bright white smile and the rosy lips make us envy them as we tried so hard to be just like them. When we hit our teenage years, as we become more aware of our body we start to dislike what we see on us, because we look quite different from that prefect girl featured on those ad's and posters." Body dissatisfaction and appearance is closely related to low self esteem, which make depression more likely to surface. When it comes to boys, they don't usually pay as much attention to their physical traits as girls do. In fact, boys tend to like the changes their bodies undergo, as they favor the increase in muscle mass and the associated pubertal changes.

The science

Communication system is essential to all of the brain's functions as the neurons are communicating with each other by exchanging neurotransmitters. Depression is characterized by the imbalance between the three neurotransmitters dopamine, serotonin and norepinephrine. Serotonin and norepinephrine regulate many important physiological functions such as mood, sleep, eating, and sexual behavior; once this chemicals are decreased than people are prone to depression. When the serotonin molecules are released to the synaptic junction for the other neuron to receive the message, many of them get destroyed in the synaptic junction because the other neuron doesn't absorb message sent by the other neuron. Due to the lack of passing on the message to the other neurons, the emotion will be lost.

Getting better...

There are two major types of therapy, biochemical and psychological. Biochemical treatments involve drugs that will help stabilize the neurotransmitter imbalance, primarily with serotonin and norepinephrine activity. Antidepressants are the most common medication used to treat depression as they help ease these imbalances. Psychological therapy involves psychoanalysis, or what we call today the "talk therapies". The licensed psychologist has sessions with the person who suffers from the disorder as they discuss the problem and the ways of overcoming it. Use of biochemical and psychological treatments have proven to be more effective when combined together. The patient takes medication to restore the chemical balance in their brain, all while seeing a therapist at the same time, to talk things out so the patient is not overwhelmed with different emotions and the mind equilibrium is kept.